Facing the unprecedented COVID-19 public health emergency, CMS released the 2021 OPPS proposed rule later than ever before, with the agency generally reinforcing its recent focus on site-neutral payment policies, lowering reimbursement for drugs purchased under the 340B program, and adding more services to the list of prior authorization.
CMS on July 24 released Transmittal 10230 to inform Medicare contractors of five new Clinical Laboratory Improvement Amendments (CLIA) waived tests approved by the Food and Drug Administration.
Physicians and facilities use the same codes to report E/M levels for ED services, but follow different rules. Outpatient coders must be able to assign E/M codes for both physicians’ work and resources utilized by the facility during emergency visits.
CMS released the 2021ICD-10-CM Official Guidelines for Coding and Reporting on July 8, several weeks earlier than usual. The coding guidelines, which take effect October 1, include new instructions for reporting manifestations of the novel coronavirus (COVID-19), among other changes.
CMS recently issued a major update to frequently asked questions (FAQ) on COVID-19 fee-for-service billing issues. The bulk of the new FAQs concerns hospitals and the ability to invoke various waivers in order to deliver services to patients in their homes using telecommunications technologies.
The Centers for Disease Control (CDC) posted the fiscal year (FY) 2021 ICD-10-CM final code changes last week. There were no changes to the proposed list of 490 new, 47 revised, and 58 invalidated codes that were released in the proposed FY 2021 Inpatient Prospective Payment System rule.
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a rich source of data. Consider how to use the PEPPER to guide coding and CDI process improvements.
CMS recently released updates to National Correct Coding Initiative (NCCI) Medically Unlikely Edits (MUE) for provider services. Effective July 1, the update will restore the MUEs that CMS deleted with an off-schedule revision and assign an MUE value of 24 to dozens of services.
CMS released several new HCPCS codes for laboratory testing services, effective July 1, as part of its quarterly update to the Clinical Laboratory Fee Schedule (CLFS).
